Addressing critical gaps in the treatment of eating disorders

Abstract

Remarkable progress has been made in developing psychosocial interventions for eating disorders and other mental disorders. Two priorities in providing treatment consist of addressing the research-practice gap and the treatment gap. The research-practice gap pertains to the dissemination of evidence-based treatments from controlled settings to routine clinical care. Closing the gap between what is known about effective treatment and what is actually provided to patients who receive care is crucial in improving mental health care, particularly for conditions such as eating disorders. The treatment gap pertains to extending treatments in ways that will reach the large number of people in need of clinical care who currently receive nothing. Currently, in the United States (and worldwide), the vast majority of individuals in need of mental health services for eating disorders and other mental health problems do not receive treatment. This article discusses the approaches required to better ensure: 1) that more people who are receiving treatment obtain high-quality, evidence-based care, using such strategies as train-the-trainer, web-centered training, best-buy interventions, electronic support tools, higher-level support and policy; and 2) that a higher proportion of those who are currently underserved receive treatment, using such strategies as task shifting and disruptive innovations, including treatment delivery via telemedicine, the Internet, and mobile apps.

Randomized controlled trial comparing smartphone assisted versus traditional guided self‐help for adults with binge eating

“…Specialty treatment is available to a limited number of eating disorder patients in the United States (Kazdin, Fitzsimmons‐Craft, & Wilfley, ). To increase accessibility, investigators developed and tested a range of self‐help programs for bulimia nervosa (BN) and binge‐eating disorder (BED) based on cognitive‐behavior therapy (CBT; Grilo & Masheb, ; Mitchell et al, ; Walsh, Fairburn, Mickley, Sysko, & Parides, ; Wilson, Wilfley, Agras, & Bryson, ).…”

Online prevention of disordered eating in at-risk young-adult women: a two-country pragmatic randomized controlled trial

“…Online delivery holds the appeal of sidestepping two important gaps in reducing the burden of mental illness (Kazdin et al , 2017, Patel et al , 2011): the research-practice gap (efficacious delivery of evidence-based programs in the real world); and, the treatment gap (discrepancy between those who could benefit from services and those who receive such services). Specifically, ‘pure self-help’ online interventions (i.e., no personalized online therapist moderator) do not require training of health providers to deliver– the intervention is designed by the specialist, made available online and then accessed directly by individuals at scale.…”

Clinicians' perspective on an app for patient self‐monitoring in eating disorder treatment

“…To our knowledge, this study is the first of its kind to explore the clinical perspective on RR as part of blended ED treatment. Thus, it is an important advance towards filling the information gap in relation to ED treatment apps (Kazdin, Fitzsimmons‐Craft, & Wilfley, ). However, our study also has limitations.…”